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Rojo J, Cervigón P, Ferencova Z, Cascón Á, Galán Díaz J, Romero-Morte J, Sabariego S, Torres M, Gutiérrez-Bustillo AM. Assessment of environmental risk areas based on airborne pollen patterns as a response to land use and land cover distribution. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123385. [PMID: 38242303 DOI: 10.1016/j.envpol.2024.123385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/21/2024]
Abstract
Allergic respiratory diseases are considered to be among the most important public health concerns, and pollen is the main cause of allergic respiratory diseases worldwide. However, the biological component of air quality is largely underestimated, and there is an important gap in the legislation in this area. The aims of this study were to characterise the occurrence and incidence of pollen exposure in relation to potential pollen sources and to delineate the main areas of aerobiological risk in the Madrid Autonomous Region based on homogeneous patterns of pollen exposure. This study uses the historical aerobiological database of the Madrid Region Palynological Network (central Spain) from ten pollen stations from 1994 to 2022, and the land-use information from the Corine Land Cover. Multiple clustering approaches were followed to group the sampling stations and subsequently all the 1 × 1km pixels for the Madrid Autonomous Region. The clustering dendrogram for land-use distribution was compared to the dendrogram for historical airborne pollen data. The two dendrograms showed a good alignment with a very high correlation (0.95) and very low entanglement (0.15), which indicates a close correspondence between the distribution of the potential pollen sources and the airborne pollen dynamics. Based on this knowledge, the Madrid Autonomous Region was divided into six aerobiological risk areas following a clear anthropogenic gradient in terms of the potential pollen sources that determine pollen exposure in the Madrid Region. Spatial regionalisation is a common practice in environmental risk assessment to improve the application of management plans and optimise the air quality monitoring networks. The risk areas proposed by scientific criteria in the Madrid Autonomous Region can be adjusted to other operational criteria following a framework equivalent to other air quality networks.
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Affiliation(s)
- Jesús Rojo
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.
| | - Patricia Cervigón
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.
| | | | - Ángel Cascón
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.
| | - Javier Galán Díaz
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain; Department of Plant Biology and Ecology, University of Sevilla, Sevilla, Spain.
| | - Jorge Romero-Morte
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.
| | - Silvia Sabariego
- Department of Biodiversity, Ecology and Evolution, University Complutense of Madrid, Madrid, Spain.
| | - Margarita Torres
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.
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Pantoja-Arévalo L, Gesteiro E, Matthias T, Urrialde R, González-Gross M. Association between Food-Specific Immunoglobulin G 4 Antibodies in Adults with Self-Reported Signs and Symptoms Attributed to Adverse Reactions to Foodstuffs. Biomedicines 2023; 11:3335. [PMID: 38137556 PMCID: PMC10742047 DOI: 10.3390/biomedicines11123335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Signs and symptoms attributed to adverse reactions to foodstuffs (ARFS) need tools for research and evaluation in clinical practice. The objectives of this study were (a) to evaluate the most frequent self-reported signs and symptoms attributed to ARFS in Spanish adults, (b) to determine the prevalence of food-specific IgG4 antibody reactions (AbRs), and (c) to investigate the association between self-reported ARFS symptomatology and food-specific IgG4 AbRs. Food-specific IgG4 AbRs against 57 common food and beverages (AESKUCARE-T2FA® in vitro point-of-care test kit, Aesku.Diagnostics GmbH, Germany) were determined in capillary blood samples of 205 volunteers living in the Region of Madrid (Spain). The most frequent self-reported signs and symptoms were related to skin (43%), digestive (41%), and nervous system (NS, 33%) problems. The prevalence of food-specific IgG4 AbRs was cow's milk (73%), sheep's milk (70%), casein (66%), and goat's milk (56.10%). Positive IgG4 AbRs against tomato had a profile consisting of 3/4 of skin problems, more than half of digestive, and 2/5 of NS self-reported signs and symptoms. In conclusion, at least 1/3 of the studied sample reported skin, digestive, and NS signs and symptoms. The most frequent food-specific IgG4 AbRs were related to dairy. Skin problems were more frequent in positive tomato IgG4 AbRs.
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Affiliation(s)
- Lisset Pantoja-Arévalo
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (E.G.); (M.G.-G.)
- EXERNET Spanish Research Network on Physical Exercise and Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Eva Gesteiro
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (E.G.); (M.G.-G.)
- EXERNET Spanish Research Network on Physical Exercise and Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Torsten Matthias
- Department of Research and Development, Aesku.Diagnostics GmbH, 55234 Wendelsheim, Germany
| | - Rafael Urrialde
- Department of Genetics, Physiology and Microbiology, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Department of Pharmaceutical and Health Sciences, Universidad San Pablo CEU, 28040 Madrid, Spain
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (E.G.); (M.G.-G.)
- EXERNET Spanish Research Network on Physical Exercise and Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Biomedical Research Centre of Pathophysiology, Obesity and Nutrition-CIBERobn, Carlos III Health Institute, 28040 Madrid, Spain
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Alarcón M, Rodríguez-Solà R, Casas-Castillo MC, Molero F, Salvador P, Periago C, Belmonte J. Influence of synoptic meteorology on airborne allergenic pollen and spores in an urban environment in Northeastern Iberian Peninsula. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 896:165337. [PMID: 37414168 DOI: 10.1016/j.scitotenv.2023.165337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
The influence of the most frequent patterns of synoptic circulation on the dynamics of airborne pollen/spores recorded at the Barcelona Aerobiological Station (BCN) was analysed. Six pollen types (Platanus, Cupressaceae, Olea, Poaceae, Urticaceae and Amaranthaceae), and one fungal spore (Alternaria) were selected for their high allergenic effect in sensitive people. Six synoptic meteorological patterns were identified through cluster analysis of sea level pressure fields as the main responsible of the weather conditions in the Iberian Peninsula. The local meteorological conditions in Barcelona associated with each one of the synoptic types were also stablished. Different statistical methods were applied to analyse possible relationships between concentrations and timing of the recorded aerobiological particles and specific synoptic types. The study, focused in the 19-year period 2001-2019, shows that one of the scenarios, frequent in winter and linked to high stability and air-mass blockage, registered the highest mean and median values for Platanus and Cupressaceae, but it was not very relevant for the other taxa. It was also this scenario that turned out to be the most influent on the pollination timing showing a significant influence on the start occurrence of Urticaceae flowering and on the peak date of Platanus. On the other hand, the most frequent synoptic type in the period, relevant in spring and summer, was linked to sporadic episodes of levels considered to be of high risk of allergy to Platanus, Poaceae, and Urticaceae pollen, and Alternaria fungal spore. This synoptic pattern, characterized by the presence of the Azores anticyclone and the Atlantic low located in the north of the United Kingdom, was associated with high temperatures, low relative humidity and moderate winds from the NW in Barcelona. The identification of an interaction between synoptic meteorology and pollen/spore dynamics will allow better abatement measures, reducing adverse health effects on sensitive population.
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Affiliation(s)
- Marta Alarcón
- Departament de Física, EEBE, Universitat Politècnica de Catalunya·BarcelonaTech, Eduard Maristany 16, 08019 Barcelona, Spain.
| | - Raül Rodríguez-Solà
- Departament de Física, ETSEIB, Universitat Politècnica de Catalunya·BarcelonaTech, Diagonal 647, 08028 Barcelona, Spain.
| | - M Carmen Casas-Castillo
- Departament de Física, ESEIAAT, Universitat Politècnica de Catalunya·BarcelonaTech, Colom 1, 08222 Terrassa, Spain.
| | - Francisco Molero
- Departamento de Medio Ambiente, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 22, 28040 Madrid, Spain.
| | - Pedro Salvador
- Departamento de Medio Ambiente, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 22, 28040 Madrid, Spain.
| | - Cristina Periago
- Departament de Física, EEBE, Universitat Politècnica de Catalunya·BarcelonaTech, Eduard Maristany 16, 08019 Barcelona, Spain.
| | - Jordina Belmonte
- Departament de Biologia Animal, Biologia Vegetal i Ecologia, Facultat de Biociències, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain; Institut de Ciència i Tecnologia Ambientals (ICTA-UAB), Universitat Autònoma de Bellaterra, 08193 Bellaterra, Spain.
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Plaza Moral V, Alobid I, Álvarez Rodríguez C, Blanco Aparicio M, Ferreira J, García G, Gómez-Outes A, Garín Escrivá N, Gómez Ruiz F, Hidalgo Requena A, Korta Murua J, Molina París J, Pellegrini Belinchón FJ, Plaza Zamora J, Praena Crespo M, Quirce Gancedo S, Sanz Ortega J, Soto Campos JG. GEMA 5.3. Spanish Guideline on the Management of Asthma. OPEN RESPIRATORY ARCHIVES 2023; 5:100277. [PMID: 37886027 PMCID: PMC10598226 DOI: 10.1016/j.opresp.2023.100277] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
The Spanish Guideline on the Management of Asthma, better known by its acronym in Spanish GEMA, has been available for more than 20 years. Twenty-one scientific societies or related groups both from Spain and internationally have participated in the preparation and development of the updated edition of GEMA, which in fact has been currently positioned as the reference guide on asthma in the Spanish language worldwide. Its objective is to prevent and improve the clinical situation of people with asthma by increasing the knowledge of healthcare professionals involved in their care. Its purpose is to convert scientific evidence into simple and easy-to-follow practical recommendations. Therefore, it is not a monograph that brings together all the scientific knowledge about the disease, but rather a brief document with the essentials, designed to be applied quickly in routine clinical practice. The guidelines are necessarily multidisciplinary, developed to be useful and an indispensable tool for physicians of different specialties, as well as nurses and pharmacists. Probably the most outstanding aspects of the guide are the recommendations to: establish the diagnosis of asthma using a sequential algorithm based on objective diagnostic tests; the follow-up of patients, preferably based on the strategy of achieving and maintaining control of the disease; treatment according to the level of severity of asthma, using six steps from least to greatest need of pharmaceutical drugs, and the treatment algorithm for the indication of biologics in patients with severe uncontrolled asthma based on phenotypes. And now, in addition to that, there is a novelty for easy use and follow-up through a computer application based on the chatbot-type conversational artificial intelligence (ia-GEMA).
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Affiliation(s)
| | - Isam Alobid
- Otorrinolaringología, Hospital Clinic de Barcelona, España
| | | | | | - Jorge Ferreira
- Hospital de São Sebastião – CHEDV, Santa Maria da Feira, Portugal
| | | | - Antonio Gómez-Outes
- Farmacología clínica, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, España
| | - Noé Garín Escrivá
- Farmacia Hospitalaria, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | | | - Javier Korta Murua
- Neumología Pediátrica, Hospital Universitario Donostia, Donostia-San, Sebastián, España
| | - Jesús Molina París
- Medicina de familia, semFYC, Centro de Salud Francia, Fuenlabrada, Dirección Asistencial Oeste, Madrid, España
| | | | - Javier Plaza Zamora
- Farmacia comunitaria, Farmacia Dr, Javier Plaza Zamora, Mazarrón, Murcia, España
| | | | | | - José Sanz Ortega
- Alergología Pediátrica, Hospital Católico Universitario Casa de Salud, Valencia, España
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Gaudin C, Ryan D, Demoly P, Tanno LK. Drug allergy in primary care: systematic review to support quality improvement initiative of management and optimization of healthcare pathways. Curr Opin Allergy Clin Immunol 2023; 23:263-270. [PMID: 37357792 DOI: 10.1097/aci.0000000000000924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
PURPOSE OF REVIEW The aim of this study was to review the practice of general practitioners (GPs) in regard to the diagnosis and management of drug hypersensitivity reactions (DHRs) to identify major challenges and to facilitate the development of decision support tools to GPs confronted with DHRs patients. RECENT FINDINGS DHRs are still a challenge in the GPs clinical practice, which implies difficulties in clinical decisions and referral to allergy specialists. SUMMARY DHRs can range from mild to severe and even life-threatening. Drugs are the main cause of anaphylaxis deaths in most countries. Most DHRs are firstly seen by GPs, paediatricians or emergency doctors. However, our systematic review demonstrated difficulties in differentiating DHRs from other drug side effects. Most DHRs epidemiological data are from hospital and emergency departments, which may not reflect the real-life experience in primary care. GPs should be aware of the alert signs of DHRs: the involvement of other systems beyond the skin and/or atypical skin/ mucosal involvement, which mandated immediate referral to an emergency department. Data still stress difficulties in the recognition of DHRs clinical manifestations and highlight the need for decision aids to support their management by GPs. Structured clinical history and clinical examination are key diagnostic tools. Reasons for referring to allergy specialists based on the literature are to investigate cause, to undergo specific procedure, such as desensitization and to identify well tolerated, alternative drugs.
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Affiliation(s)
- Clara Gaudin
- University Hospital of Montpellier, Montpellier, France
| | - Dermot Ryan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Doorway 3, Medical School, Teviot Place, Edinburgh, UK
| | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA-11, University of Montpellier - INSERM
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Luciana Kase Tanno
- University Hospital of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA-11, University of Montpellier - INSERM
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
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6
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Antón M, Cabañes N, Fernández-Meléndez S, Fernández-Nieto M, Jiménez-Ferrera G, Letrán A, Méndez-Brea P, Montoro J, Moreno F, Mur-Gimeno P, Rodríguez-Vázquez V, Rosado A, Sánchez-Guerrero I, Vega-Chicote JM, Vidal C. Shared Decision-Making in Allergen Immunotherapy (AIT) Options Using a Questionnaire for Respiratory Allergic Patients: A Delphi Consensus Study. Patient Prefer Adherence 2023; 17:1771-1782. [PMID: 37520065 PMCID: PMC10378527 DOI: 10.2147/ppa.s409466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/10/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose The objective of this study was to develop and validate a questionnaire, through a Delphi consensus, to be used by allergists in their routine clinical practice to assess the preferences of patients starting allergen immunotherapy (AIT) treatment using an objective approach. Patients and Methods A Delphi consensus-driven process was used. The scientific committee, composed of 15 allergists, led the study and participated in the preparation of the questionnaire. Two-hundred panelists from different Spanish regions were invited to complete a 16-item questionnaire on a nine-point Likert scale covering six topic blocks. Consensus was achieved if ≥66.6% of panelists reached agreement or disagreement. Results Of the 200 experts invited to participate in the Delphi process, a total of 195 (97.5%) answered the questionnaire. The panel experts reached a consensus on "agreement" on a total of 12 of the 16 (75.0%) items, covering a total of six categories: (a) patient knowledge (2 questions), (b) barriers to patient adherence (3 questions), (c) patient behavior (4 questions), (d) future actions (3 questions), (e) treatment costs (2 questions), and (f) final patient preferences (2 questions). Conclusion This Delphi consensus study validated a set of twelve recommended questions for patients objectively assessing their preferences and suitability for the most common AIT options available. The questionnaire intends to assist allergists in making an objective, unconditioned decision regarding the best AIT option for each patient, after informing them about the different routes.
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Affiliation(s)
- Mónica Antón
- Allergy Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Nieves Cabañes
- Allergy Department, Hospital Universitario de Toledo, Toledo, Spain
| | | | - Mar Fernández-Nieto
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | - Antonio Letrán
- Allergy Unit, Centro médico Asisa Doctor Lobatón, Cádiz, Spain
| | - Paula Méndez-Brea
- Allergy Department, Complejo Hospitalario Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - Javier Montoro
- Allergy Department, Hospital de Llíria, Valencia, Spain
- Department of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | | | - Pilar Mur-Gimeno
- Allergy Department, Hospital de Santa Bárbara, Puertollano, Ciudad Real, Spain
| | - Virginia Rodríguez-Vázquez
- Allergy Department, Complejo Hospitalario Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Rosado
- Allergy Department, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | | | - Carmen Vidal
- Allergy Department, Complejo Hospitalario Clínico Universitario de Santiago, Santiago de Compostela, Spain
- Department of Medicine, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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González-Pérez R, Poza-Guedes P, Pineda F. Comment on Platts-Mills et al. Pediatr Allergy Immunol 2023; 34:e13986. [PMID: 37492915 DOI: 10.1111/pai.13986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, Tenerife, Spain
- Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, Tenerife, Spain
- Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain
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Sara BV, Ulrike F, Bettina B, Yvonne W, Teresa P, Clara SB, Giovanna AS, Rocío CS, María T, Rocío L, Rosa MC, Joan B, Waltraud S, Mariona P. Improving In Vitro Detection of Sensitization to Lipid Transfer Proteins: A New Molecular Multiplex IgE Assay. Mol Nutr Food Res 2023; 67:e2200906. [PMID: 37195823 DOI: 10.1002/mnfr.202200906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/11/2023] [Indexed: 05/19/2023]
Abstract
SCOPE LTP-syndrome is characterized by sensitization (IgE) to multiple non-specific lipid transfer proteins (nsLTPs) with a variable clinical outcome. The treatment is primarily based on offending food avoidance. However, the determination of Pru p 3-specific IgE is currently the main diagnostic tool to assess sensitization to nsLTPs. Herein, the study evaluates improvement of LTP-syndrome diagnosis and clinical management using a new IgE multiplex-immunoblot assay with a high diversity of food nsLTPs. METHODS AND RESULTS An EUROLINE-LTP strip with 28 recombinant nsLTPs from 18 allergenic sources is designed. In total the study investigates 38 patients with LTP-syndrome and compares results from the nsLTPs (LTP-strip) with the respective food extracts of Prick-by-prick (PbP) testing. The agreement exceeds 70% for most nsLTPs, e.g., Pru p 3 (100%), Mal d 3 (97%), Pru av 3 (89%), Pha v 3 isoforms (87%/84%), Ara h 9 (82%), Cor a 8 (82%), and Jug r 3 (82%). The functionality and allergenic relevance of nine recombinant nsLTPs are proven by Basophil activation testing (BAT). CONCLUSIONS The new IgE multiplex-immunoblot nsLTP assay shows a good diagnostic performance allowing culprit food assessment. Negative results from LTP-strip may indicate potentially tolerable foods, improving diet intervention and patients' quality of life.
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Affiliation(s)
- Balsells-Vives Sara
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, 08036, Spain
| | - Flügge Ulrike
- EUROIMMUN AG A PerkinElmer Company, 23560, Lübeck, Germany
| | - Brix Bettina
- EUROIMMUN AG A PerkinElmer Company, 23560, Lübeck, Germany
| | - Weimann Yvonne
- EUROIMMUN AG A PerkinElmer Company, 23560, Lübeck, Germany
| | - Peralta Teresa
- Department of Clinical Immunology and Rheumatology, Pontificia Universidad Católica de Chile, 8331150, Santiago, Chile
| | - San Bartolomé Clara
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, 08036, Spain
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, 08036, Spain
| | - Araujo-Sánchez Giovanna
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, 08036, Spain
- Allergy Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Casas-Saucedo Rocío
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, 08036, Spain
- Allergy Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Universitat de Barcelona, Barcelona, 08036, Spain
- RETIC Asma, Reacciones Adversas a Fármacos y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Torradeflot María
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, 08036, Spain
| | - Lara Rocío
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, 08036, Spain
| | - Munoz-Cano Rosa
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, 08036, Spain
- Allergy Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Universitat de Barcelona, Barcelona, 08036, Spain
- RETIC Asma, Reacciones Adversas a Fármacos y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Bartra Joan
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, 08036, Spain
- Allergy Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Universitat de Barcelona, Barcelona, 08036, Spain
- RETIC Asma, Reacciones Adversas a Fármacos y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III, Madrid, 28029, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Campus Clínic, Universitat de Barcelona (UB), c. Casanova, 143, Barcelona, 08036, Spain
| | - Suer Waltraud
- EUROIMMUN AG A PerkinElmer Company, 23560, Lübeck, Germany
| | - Pascal Mariona
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, 08036, Spain
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, 08036, Spain
- RETIC Asma, Reacciones Adversas a Fármacos y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III, Madrid, 28029, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Campus Clínic, Universitat de Barcelona (UB), c. Casanova, 143, Barcelona, 08036, Spain
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In Vitro Assays for Diagnosis of Drug-Induced Nonsevere Exanthemas: A Systematic Review and Meta-Analysis. J Immunol Res 2022; 2022:2386654. [PMID: 36590449 PMCID: PMC9797304 DOI: 10.1155/2022/2386654] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Frequent mislabelled causal relationship between drug hypersensitivity reactions and culprit drugs reinforces the need for an accurate diagnosis. The systematic reviews and meta-analyses of in vitro assays published so far focused on immediate reactions and the most severe delayed reactions, while the most frequent drug-induced delayed reactions-nonsevere exanthemas-have been underestimated. We aim to fill this gap. A systematic review of studies on in vitro assays used in the diagnosis of nonsevere drug-induced delayed reactions was conducted following the methodology of Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies Statement. The EMBASE and PubMed databases were searched. We have included 33 studies from which we extracted the data, then performed meta-analysis where possible, or synthesised the evidence narratively. The quality of the analysed studies was assessed with the QUADAS-2 tool. The tests identified the most frequently were lymphocyte transformation test (LTT), ELISpot, and ELISA. In the meta-analysis carried out for LTT in reactions induce by beta-lactams, the pool estimate of sensitivity and specificity amounted to 49.1% (95% CI: 14.0%, 85.0%) and 94.6% (95% CI: 81.7%, 98.6%), respectively. The studies showed heterogeneity in study design and laboratory settings, which resulted in a wide range of specificity and sensitivity of testing.
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Tobajas AP, Agulló-García A, Cubero JL, Colás C, Civera A, Condón S, Sánchez L, Pérez MD. Effect of thermal and ultrasound treatments on denaturation and allergenic potential of Pru p 3 protein from peach. Eur Food Res Technol 2022. [DOI: 10.1007/s00217-022-04147-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractThe effect of thermal and ultrasound treatments on denaturation and allergenicity of Pru p 3, the major peach allergenic protein, was determined. The degree of denaturation of Pru p 3 was estimated by sandwich ELISA using specific rabbit IgG, that was previously developed. Validation of ELISA test showed high sensitivity and specificity, and acceptable results of precision and robustness. Allergenicity of Pru p 3 was determined by immunofluorescent assay using three pools of sera from peach allergic individuals. Denaturation of Pru p 3 was dependent on the intensity of the thermal treatment applied and the treatment medium. Thus, the degree of denaturation of Pru p 3 treated at 95 °C for 40 min was about 60% and 95%, for the protein heated in peach extract and in buffer, respectively. Ultrasound treatments denatured Pru p 3 up to 60%, being dependent on amplitude and pressure. However, both heat and ultrasound treatments at the most severe conditions applied inhibited less than 10% the IgE-binding of Pru p 3. These results indicate that although heat and ultrasound treatments induce a considerable denaturation of Pru p 3, they are not effective in reducing its allergenicity.
Graphical abstract
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11
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Luri M, Gastaminza G, Idoate A, Ortega A. Allergic Adverse Drug Events After Alert Overrides in Hospitalized Patients. J Patient Saf 2022; 18:630-636. [PMID: 35617638 DOI: 10.1097/pts.0000000000001034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to assess how often overridden drug allergy alerts (ODAAs) lead to allergic adverse drug events (All-ADEs) and to evaluate the frequency with which drug allergy alerts (DAAs) were overridden and the reasons, as well as appropriateness of these overrides. METHODS A retrospective observational study of DAA generated between 2014 and 2016 was conducted. The corresponding DAA records were reviewed to determine the frequency of alert overrides. A chart review was performed on a subset of 194 ODAA (the first of every 3 chronologically ordered ODAA) to identify All-ADEs and to evaluate the override reasons and the appropriateness of these overrides. RESULTS A total of 2044 DAAs were overridden (override rate of 44.8%). Most were triggered by a nonexact match (93.81%), when ordering nervous system (21.1%) and cardiovascular system (19.6%) drugs and were generated by physicians (72.7%). The main override reason was that the patient was already taking the drug or had previously tolerated the drug. Only 9.28% of ODAAs were inappropriately overridden. Six All-ADEs (3.09%) were identified and were due to anti-infective (1), antineoplastic (1), and iodinated-contrast (4) drug administration. Most All-ADEs were cutaneous and were mild. None was life-threatening or fatal. The All-ADEs rate was higher among inappropriately ODAA (15.79%, P = 0.013). CONCLUSIONS Alert overrides are not exempt from clinical consequences, although few are associated with All-ADEs. It is necessary to identify the drugs involved in those reactions and to update allergy lists to generate only specific and important DAA and to avoid the negative consequences of overrides.
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Padró C, Gutiérrez D, Moreno F, Parra A, Rial MJ, Lleonart R, Torán‐Barona C, Justicia JL, Roger A. Effectiveness and safety of a microcrystalline tyrosine‐adjuvanted
Dermatophagoides pteronyssinus
allergoid immunotherapy in adult patients with allergic asthma and rhinitis: A real‐life prospective observational study. Immun Inflamm Dis 2022; 10:e585. [PMID: 35478444 PMCID: PMC9017636 DOI: 10.1002/iid3.585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/18/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction Although clinical trials have shown the efficacy and safety of allergen‐specific immunotherapy (AIT) in the treatment of allergic asthma, there is a need for real‐life studies. We aimed to assess the effectiveness and safety of a microcrystalline tyrosine‐adjuvanted Dermatophagoides pteronyssinus allergoid (Acarovac Plus®) in patients with house dust mite (HDM)‐induced allergic asthma in a real‐life study. Methods A subanalysis of a multicenter, prospective, observational, real‐life study. Patients with rhinitis and allergic asthma caused by HDMs were assessed before AIT with Acarovac Plus® and at 6 and 12 months after this treatment. Assessment parameters were percentage of days with asthma symptoms, percentage of days on asthma medication, classification of asthma according to Spanish guidelines for the management of asthma, asthma‐related quality of life (quality of life in adults with asthma questionnaire [QLAAQ]), perception of symptoms (visual analog scale [VAS]), and treatment satisfaction (treatment satisfaction questionnaire for medication [TSQM]). Safety was assessed by the number and severity of adverse reactions. Results This subanalysis included 55 patients. Treatment with Acarovac Plus® showed significant differences in the analyzed variables when the baseline visit was compared with the 12‐month visit: reduction of the mean (SD) percentage of days with asthma symptoms (23.9 [9.2] vs. 5.1 [12.8]; p = .002), of the mean [SD] percentage of days on asthma medication (67.6 [42.9] vs. 45.1 [46.8]; p = .002), and of the percentage of patients with persistent asthma (78.2% vs. 38.9%; p = .009). Acarovac Plus® significantly improved asthma‐related quality of life, as shown by a decrease of 1.39 points in QLAAQ score at 12 months (p < .001), and in the subjective perception of symptoms on the VAS (−3.50, p < .0001). Patients showed high treatment satisfaction according to the TSQM, and it was well tolerated. No serious adverse events were reported. Conclusions Acarovac Plus® was effective and safe for the treatment of patients with HDM‐induced allergic asthma in a real‐life study.
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Affiliation(s)
- Clara Padró
- Allergy Section Hospital Universitari Germans Trias i Pujol Badalona Spain
| | - Diego Gutiérrez
- Clínica Médico Asistencial Virgen del Rosario Algeciras Spain
| | | | - Antonio Parra
- Allergy Department Complexo Hospitalario Universitario A Coruña A Coruña Spain
| | - Manuel J. Rial
- Allergy Department Complexo Hospitalario Universitario A Coruña A Coruña Spain
| | - Ramón Lleonart
- Allergy Unit Hospital Universitari de Bellvitge L'Hospitalet de Llobregat Spain
| | | | | | - Albert Roger
- Allergy Section Hospital Universitari Germans Trias i Pujol Badalona Spain
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Bøgelund M, Ingelmo AR, Ruiz JMA, Vivó AG, Brandi H, Pedersen MH, Loftager ASL, Aagren M. Preference for sublingual immunotherapy with tablets in a Spanish population with allergic rhinitis. Clin Transl Allergy 2022; 12:e12118. [PMID: 35140910 PMCID: PMC8814907 DOI: 10.1002/clt2.12118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background This study investigated patients' preference for allergy immunotherapy (AIT) administered as either sublingual immunotherapy‐tablets versus monthly or weekly subcutaneous immunotherapy (SCIT) from a Spanish patient perspective. Methods A discrete choice experiment (DCE) consisting of two blocks with eight choice sets in each was constructed to elicit the preferences for AIT. Three attributes were included in the DCE for the mode of administration, including the frequency of administration, the risk of systemic reactions and the co‐payment. Adults and caregivers of children with moderate to severe allergic rhinitis (AR) were included if they were not currently receiving or had not previously received AIT. Results In total, 587 adults and 613 caregivers started the survey. Of those, 579 adults and 611 caregivers completed the survey and were included in the study. Both adults and caregivers had a significant preference for tablets compared with both monthly and weekly injections (p ≤ 0.0001). Furthermore, the respondents showed a significant preference for reducing the risk of systemic reactions. Subgroup analyses showed that caregivers of polyallergic children and female caregivers were significantly less price sensitive when choosing their preferred treatment. Conclusion Our study demonstrated that both adults with AR and caregivers of children with AR prefer daily SLIT‐tablets to SCIT with either a weekly or monthly dose schedule.
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Affiliation(s)
| | | | | | | | - Henrik Brandi
- Global Market Access & Public AffairsALKHørsholmDenmark
- Global Pricing & Market AccessLEO PharmaBallerupDenmark
| | | | | | - Mark Aagren
- Global Market Access & Public AffairsALKHørsholmDenmark
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14
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AAD Guidelines: awareness of comorbidities associated with atopic dermatitis in adults. J Am Acad Dermatol 2022; 86:1335-1336.e18. [DOI: 10.1016/j.jaad.2022.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/21/2022]
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Mayorga C, Perez‐Inestrosa E, Rojo J, Ferrer M, Montañez MI. Role of nanostructures in allergy: Diagnostics, treatments and safety. Allergy 2021; 76:3292-3306. [PMID: 33559903 DOI: 10.1111/all.14764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 01/08/2023]
Abstract
Nanotechnology is science, engineering and technology conducted at the nanoscale, which is about 1-100 nm. It has led to the development of nanomaterials, which behave very differently from materials with larger scales and can have a wide range of applications in biomedicine. The physical and chemical properties of materials of such small compounds depend mainly on the size, shape, composition and functionalization of the system. Nanoparticles, carbon nanotubes, liposomes, polymers, dendrimers and nanogels, among others, can be nanoengineeried for controlling all parameters, including their functionalization with ligands, which provide the desired interaction with the immunological system, that is dendritic cell receptors to activate and/or modulate the response, as well as specific IgE, or effector cell receptors. However, undesired issues related to toxicity and hypersensitivity responses can also happen and would need evaluation. There are wide panels of accessible structures, and controlling their physico-chemical properties would permit obtaining safer and more efficient compounds for clinical applications goals, either in diagnosis or treatment. The application of dendrimeric antigens, nanoallergens and nanoparticles in allergy diagnosis is very promising since it can improve sensitivity by increasing specific IgE binding, mimicking carrier proteins or enhancing signal detection. Additionally, in the case of immunotherapy, glycodendrimers, liposomes, polymers and nanoparticles have shown interest, behaving as platforms of allergenic structures, adjuvants or protectors of allergen from degradation or having a depot capacity. Taken together, the application of nanotechnology to allergy shows promising facts facing important goals related to the improvement of diagnosis as well as specific immunotherapy.
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Affiliation(s)
- Cristobalina Mayorga
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA Málaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga Málaga Spain
- Andalusian Centre for Nanomedicine and Biotechnology‐BIONAND Málaga Spain
| | - Ezequiel Perez‐Inestrosa
- Andalusian Centre for Nanomedicine and Biotechnology‐BIONAND Málaga Spain
- Departamento de Química Orgánica, and the Biomimetic Dendrimers and Photonic Laboratory Instituto de Investigación Biomédica de Málaga‐IBIMAUniversidad de Málaga Málaga Spain
| | - Javier Rojo
- Glycosystems Laboratory Instituto de Investigaciones Químicas (IIQ)CSIC—Universidad de Sevilla Sevilla Spain
| | - Marta Ferrer
- Department of Allergy and Clinical Immunology Clínica Universidad de NavarraInstituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona Spain
| | - Maria Isabel Montañez
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA Málaga Spain
- Andalusian Centre for Nanomedicine and Biotechnology‐BIONAND Málaga Spain
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Cabrera M, Subiza J, Fernández-Caldas E, Garzón García B, Moreno-Grau S, Subiza JL. Influence of environmental drivers on allergy to pollen grains in a case study in Spain (Madrid): meteorological factors, pollutants, and airborne concentration of aeroallergens. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:53614-53628. [PMID: 34032952 DOI: 10.1007/s11356-021-14346-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to compare airborne levels of Phl p 1 and Phl p 5, with Poaceae pollen concentrations inside and outside of the pollen season, and to evaluate their association with symptoms in grass allergic patients and the influence of climate and pollution. The Hirst and the Burkard Cyclone samplers were used for pollen and allergen quantification, respectively. The sampling period ran from 23 March 2009 to 27 July 2010. Twenty-three patients with seasonal allergic asthma and rhinitis used an electronic symptom card. The aerosol was extracted and quantified for Phl p 1 and Phl p 5 content. Descriptive statistics, non-parametric paired contrast of Wilcoxon, Spearman's correlations, and a categorical principal component analysis (CatPCA) were carried out. Significant variations in pollen, aeroallergen levels, pollen allergen potency, and symptoms score were observed in this study. Phl p 5 pollen allergen potency was higher at the beginning of the 2010 grass pollen season. Presence of Phl p 1 outside the pollen season with positive O3 correlation was clinically relevant. 45.5% of the variance was explained by two dimensions in the CatPCA analysis, showing the symptom relationships dissociated in two dimensions. In the first one, the more important relationship was with grass pollen grains concentration and Phl p 5 and to a lesser extent with Phl p 1 and levels of NO2 and O3, and in the second dimension, symptoms were associated with humidity and SO2. Clinically relevant out-season Phl p 1 was found with a positive O3 correlation. The effect of climate and pollution may have contributed to the higher seasonal allergic rhinitis symptom score recorded in 2009.
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Affiliation(s)
- Martha Cabrera
- Servicio de Alergia, Hospital Los Madroños, Brunete, Madrid, Spain.
| | | | - Enrique Fernández-Caldas
- Inmunotek S.L., Alcalá de Henares, Madrid, Spain
- College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Belén Garzón García
- Unidad de Estadística, Secretaría Adjunta de Informática, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Stella Moreno-Grau
- Departamento de Ingeniería Química y Ambiental, Universidad Politécnica de Cartagena, Cartagena, Spain
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Somoza ML, Pérez-Sánchez N, Victorio-Puche L, Martín-Pedraza L, Esteban Rodríguez A, Blanca-López N, Abel Fernández González E, Ruano-Zaragoza M, Prieto-Moreno Pfeifer A, Fernández Caldas E, Morán Morales M, Fernández Sánchez FJ, López Sánchez JD, Jiménez Rodríguez TW, Subiza Garrido-Lestache JL, Canto Díez G, Blanca Gómez M, Cornejo-García JA. Subjects develop tolerance to Pru p 3 but respiratory allergy to Pru p 9: A large study group from a peach exposed population. PLoS One 2021; 16:e0255305. [PMID: 34411133 PMCID: PMC8376049 DOI: 10.1371/journal.pone.0255305] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/13/2021] [Indexed: 11/19/2022] Open
Abstract
Peach tree allergens are present in fruit, pollen, branches, and leaves, and can induce systemic, respiratory, cutaneous, and gastrointestinal symptoms. We studied the capacity of peach fruit/Pru p 1, Pru p 3, Pru p 4, Pru p 7 and peach pollen/Pru p 9 for inducing symptoms following oral or respiratory exposure in a large group of subjects. We included 716 adults (aged 21 to 83 y.o.) exposed to peach tree pollen and fruit intake in the study population. Participants completed a questionnaire and were skin tested with a panel of inhalant and food allergens, including peach tree pollen, Pru p 9 and peach fruit skin extract. Immunoglobulin E antibodies (SIgE) to Pru p 1, Pru p 3, Pru p 4 and Pru p 7 were quantified. Sensitised subjects underwent oral food challenge with peach fruit and nasal provocation test with peach tree pollen and Pru p 9. The prevalence of sensitisation to peach fruit was 5% and most of these had SIgE to Pru p 3, with a very low proportion to Pru p 4 SIgE and no SIgE to Pru p 1 and Pru p 7. In only 1.8%, anaphylaxis was the clinical entity induced. Cases with positive skin tests to peach and SIgE to Pru p 3 presented a good tolerance after oral challenge with peach fruit. The prevalence of skin sensitisation to peach tree pollen was 22%, with almost half recognising Pru p 9. This induced respiratory symptoms in those evaluated by nasal provocation. In a large population group exposed to peach fruit and peach tree pollen, most individuals were tolerant, even in those with SIgE to Pru p 3. A positive response to Pru p 9 was associated with respiratory allergy.
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Affiliation(s)
- Maria Luisa Somoza
- Allergy Department, Infanta Leonor University Hospital, Madrid, Spain
- * E-mail:
| | - Natalia Pérez-Sánchez
- Allergy Department, Hospital Regional Universitario de Málaga, Málaga-IBIMA, Málaga, Spain
| | | | - Laura Martín-Pedraza
- Allergy Department, Fundación para la Investigación e Innovación Biomédica (FIIB) de los Hospitales Universitarios Infanta Leonor y Sureste, Madrid, Spain
| | | | | | | | - María Ruano-Zaragoza
- Allergy Department, General University Hospital of Alicante- ISABIAL, Alicante, Spain
| | | | | | | | | | | | | | | | | | - Miguel Blanca Gómez
- Allergy Department, Fundación para la Investigación e Innovación Biomédica (FIIB) de los Hospitales Universitarios Infanta Leonor y Sureste, Madrid, Spain
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Ma Z, Chen L, Xian R, Fang H, Wang J, Hu Y. Time trends of childhood food allergy in China: Three cross-sectional surveys in 1999, 2009, and 2019. Pediatr Allergy Immunol 2021; 32:1073-1079. [PMID: 33651447 DOI: 10.1111/pai.13490] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Many countries have recorded the trends of food allergy (FA) prevalence. Little is known about epidemiologic trends of childhood FA in China. METHODS In three cross-sectional surveys conducted in 1999, 2009, and 2019, the prevalence of and characteristic changes in FA in children aged ≤ 2 years were assessed and the outcomes were compared. All the children were recruited during well-baby check-ups at the Children's Hospital of Chongqing Medical University. All participants had a detailed medical history taken and underwent skin prick tests using ten commercial food extracts. Open food challenges were used for confirmation of FA. RESULTS The three studies included 1228 children (314 in 1999, 401 in 2009, and 513 in 2019; response rate > 95%). The prevalence of FA in 2009 (7.7%) and 2019 (11.1%) was significantly higher than that in 1999 (3.5%). However, there was no statistically significant difference in prevalence between 2009 and 2019 (P = .086). There was evidence of increased prevalence in CMPA between 1999 and 2019 (1.6% versus 5.7%; P = .004). However, no statistic difference was found in egg allergy (2.9% versus 5.5%; P = .21). The incidence of skin symptoms did not differ significantly over the study period, while the incidence of gastrointestinal symptoms increased significantly (18.2% in 1999, 12.9% in 2009, and 43.9% in 2019; P < .05). CONCLUSIONS The prevalence of FA in children rapidly increased after the 1990s and gradually stabilized after 2010. Cow's milk has become the most common food allergen among children in Chongqing. The incidence of gastrointestinal symptoms as a manifestation of FA has increased significantly since 2010.
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Affiliation(s)
- Zhuoying Ma
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Lin Chen
- National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Ruoling Xian
- National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Heping Fang
- National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Juan Wang
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Yan Hu
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
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Beltrán-Cárdenas CE, Granda-Restrepo DM, Franco-Aguilar A, Lopez-Teros V, Arvizu-Flores AA, Cárdenas-Torres FI, Ontiveros N, Cabrera-Chávez F, Arámburo-Gálvez JG. Prevalence of Food-Hypersensitivity and Food-Dependent Anaphylaxis in Colombian Schoolchildren by Parent-Report. ACTA ACUST UNITED AC 2021; 57:medicina57020146. [PMID: 33562800 PMCID: PMC7915673 DOI: 10.3390/medicina57020146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: The epidemiology of food allergy (FA) and food-dependent anaphylaxis remains unknown in Colombia. Our aim was to estimate by parent-report the prevalence of FA and food-dependent anaphylaxis in a Colombian population of schoolchildren. Materials and methods: A printed questionnaire was sent to parents of schoolchildren aged 5–12 years old from Medellín, Colombia in order to collect FA-related data. Results: Nine hundred and sixty-nine (969) parents returned the questionnaire with valid responses (response rate, 52.5%). The estimated prevalence rates (95% CI) were: adverse food reactions 12.79% (10.76–15.07), “perceived FA, ever” 10.93% (9.08–13.08), “physician-diagnosed FA, ever” 4.33% (3.14–5.81), “immediate-type FA, ever” 6.81% (5.30–8.58), “immediate-type FA, current” 3.30% (2.26–4.63), and food-dependent anaphylaxis 1.85% (1.10–2.92). The most frequently reported food allergens were milk (1.44%), fruits (0.41%), meat (0.41%), and peanut (0.3%). Sixty-one percent of “food-dependent anaphylaxis” cases sought medical attention, but only eleven percent of the cases reported the prescription of an epinephrine autoinjector. Conclusions: FA and food-dependent anaphylaxis are not uncommon among schoolchildren from Colombia. The prescription of epinephrine autoinjectors should be encouraged among health personnel for the optimal management of suspected cases of food-dependent anaphylaxis.
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Affiliation(s)
- Carlos Eduardo Beltrán-Cárdenas
- Postgraduate Program in Nutrition Sciences, Faculty of Nutrition Sciences, University of Sinaloa, Culiacan, Sinaloa 80019, Mexico; (C.E.B.-C.); (F.I.C.-T.)
| | - Diana María Granda-Restrepo
- Food Department, Faculty of Pharmaceutical and Food Sciences, University of Antioquia, Medellín, Antioquia 50010, Colombia; (D.M.G.-R.); (A.F.-A.)
| | - Alejandro Franco-Aguilar
- Food Department, Faculty of Pharmaceutical and Food Sciences, University of Antioquia, Medellín, Antioquia 50010, Colombia; (D.M.G.-R.); (A.F.-A.)
| | - Veronica Lopez-Teros
- Postgraduate Program in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico; (V.L.-T.); (A.A.A.-F.)
| | - Aldo Alejandro Arvizu-Flores
- Postgraduate Program in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico; (V.L.-T.); (A.A.A.-F.)
| | - Feliznando Isidro Cárdenas-Torres
- Postgraduate Program in Nutrition Sciences, Faculty of Nutrition Sciences, University of Sinaloa, Culiacan, Sinaloa 80019, Mexico; (C.E.B.-C.); (F.I.C.-T.)
| | - Noé Ontiveros
- Clinical and Research Laboratory (LACIUS, URS), Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Division of Sciences and Engineering, University of Sonora, Navojoa, Sonora 85880, Mexico;
| | - Francisco Cabrera-Chávez
- Postgraduate Program in Nutrition Sciences, Faculty of Nutrition Sciences, University of Sinaloa, Culiacan, Sinaloa 80019, Mexico; (C.E.B.-C.); (F.I.C.-T.)
- Correspondence: (F.C.-C.); (J.G.A.-G.)
| | - Jesús Gilberto Arámburo-Gálvez
- Postgraduate Program in Nutrition Sciences, Faculty of Nutrition Sciences, University of Sinaloa, Culiacan, Sinaloa 80019, Mexico; (C.E.B.-C.); (F.I.C.-T.)
- Postgraduate Program in Health Sciences, Division of Biological and Health Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico; (V.L.-T.); (A.A.A.-F.)
- Correspondence: (F.C.-C.); (J.G.A.-G.)
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Ariza A, Mayorga C, Bogas G, Barrionuevo E, Torres MJ, Doña I, Fernandez TD. Advances and novel developments in drug hypersensitivity diagnosis. Allergy 2020; 75:3112-3123. [PMID: 32990987 DOI: 10.1111/all.14603] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022]
Abstract
A correct diagnosis of drug hypersensitivity reactions (DHRs) is very important for both the patient and health system. However, DHRs diagnosis is complex, time consuming, requires trained personnel, is not standardized for many drugs, involves procedures not exempt of risk, and in most cases lacks standardized in vivo and in vitro tests. Thus, there is an urgent need for improving the different approaches to diagnose patients with suspected DHRs. In this review, we have analyzed the advances performed in immediate and nonimmediate DHRs diagnosis during the last two years and obtained several conclusions: the significant heterogeneity in current practice among centers illustrates the need to re-evaluate, update, and standardize in vivo tests and protocols for the diagnosis and management of patients with suspected drug allergy. Regarding in vitro tests, the latest studies have focused on increasing their sensitivity or on establishing the sensitivity and specificity for the tests performed with new drugs. There seems to be a consensus about combining in vivo and in vitro tests as the best way to increase the diagnostic accuracy.
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Affiliation(s)
- Adriana Ariza
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA‐ARADyAL Málaga Spain
| | - Cristobalina Mayorga
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA‐ARADyAL Málaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga‐ARADyAL Málaga Spain
- Andalusian Center for Nanomedicine and Biotechnology‐BIONAND Málaga Spain
| | - Gador Bogas
- Allergy Unit Hospital Regional Universitario de Málaga‐ARADyAL Málaga Spain
| | - Esther Barrionuevo
- Asthma and Immunoallergic Diseases Research Group Instituto de Investigación Hospital 12 de Octubre (i+12)‐ARADyAL Madrid Spain
- Allergy Unit Hospital Universitario 12 de Octubre Madrid Spain
| | - Maria J. Torres
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA‐ARADyAL Málaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga‐ARADyAL Málaga Spain
- Andalusian Center for Nanomedicine and Biotechnology‐BIONAND Málaga Spain
- Departamento de Medicina Universidad de Málaga Málaga Spain
| | - Inmaculada Doña
- Allergy Unit Hospital Regional Universitario de Málaga‐ARADyAL Málaga Spain
| | - Tahia D. Fernandez
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA‐ARADyAL Málaga Spain
- Departamento de Biología Celular, Genética y Fisiología Universidad de Málaga Málaga Spain
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21
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Sánchez-Hernández MC, Navarro AM, Colás C, del Cuvillo A, Sastre J, Mullol J, Valero A. Validation of the DECA criteria for allergic conjunctivitis severity and control. Clin Transl Allergy 2020; 10:43. [PMID: 33110491 PMCID: PMC7585176 DOI: 10.1186/s13601-020-00349-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Allergic conjunctivitis (AC) is usually associated to allergic rhinitis (AR), but the severity and control of ocular symptoms should be assessed independently to improve diagnosis and treatment. The criteria from the Spanish consensus document on allergic conjunctivitis (DECA) aimed to be used as a patient-reported instrument for AC management. Here we validate these criteria for classifying AC severity and defining its control following COSMIN guidelines recommendations. METHODS Patients with moderate or severe AR [reflective total nasal symptom score (rTNSS) score ≥ 8] and concomitant AC were recruited from hospitals in Spain. Patients were classified according to the severity of ocular symptoms as mild, moderate, or severe, and classified with respect to control as controlled and non-controlled, using the DECA criteria. To validate these criteria, comparisons with the validated modified allergic rhinitis and its impact on asthma (mARIA), reflective total ocular symptom score (rTOSS), rhinitis control assessment test (RCAT), ESPRINT-15 questionnaires, a conjunctival hyperemia scale and a visual analogue scale (VAS) for ocular symptoms were performed. RESULTS A total of 128 patients participated in the validation. Mean age was 34.4 ± 12.1 years; 72.7% were women. The DECA criteria showed a good discriminant validity, reflecting a high capacity to differentiate between mild, moderate, and severe patients, and controlled from uncontrolled patients. A strong association between AC and AR was reflected in the comparison between the DECA and the mARIA criteria (p < 0.0001). The DECA criteria for severity and control presented satisfactory properties for longitudinal validity and responsiveness. CONCLUSIONS Validation of the DECA criteria for severity and control of AC suggested that it can be useful in the evaluation of eye symptoms and follow-up of therapies.
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Affiliation(s)
| | - Ana M. Navarro
- Department of Allergy, Hospital El Tomillar, Dos Hermanas, Seville Spain
- Doctor Relimpio 6, 3B, 41003 Seville, Spain
| | - Carlos Colás
- Department of Allergy, Hospital Clínico-Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Alfonso del Cuvillo
- Rhinology & Asthma Unit; Department of Otorhinolaryngology, Hospital Universitario de Jerez, Cádiz, Spain
| | - Joaquín Sastre
- Department of Allergy, Fundación Jiménez Díaz, Madrid, Spain
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Joaquim Mullol
- CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Antonio Valero
- CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Department of Pneumology and Allergy, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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22
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Tobajas AP, Agulló-García A, Cubero JL, Colás C, Segura-Gil I, Sánchez L, Calvo M, Pérez MD. Effect of high pressure and pulsed electric field on denaturation and allergenicity of Pru p 3 protein from peach. Food Chem 2020; 321:126745. [DOI: 10.1016/j.foodchem.2020.126745] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
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23
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Sanchiz A, Cuadrado C, Haddad J, Linacero R. Effect of Instant Controlled Pressure Drop (DIC) Treatment on the Detection of Nut Allergens by Real Time PCR. Foods 2020; 9:E729. [PMID: 32503109 PMCID: PMC7353585 DOI: 10.3390/foods9060729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 11/23/2022] Open
Abstract
Tree nuts show nutritional properties and human health benefits. However, they contain allergenic proteins, which make them harmful to the sensitised population. The presence of tree nuts on food labelling is mandatory and, consequently, the development of suitable analytical methodologies to detect nuts in processed foods is advisable. Real-Time PCR allowed a specific and accurate amplification of allergen sequences. Some food processing methods could induce structural and/or conformational changes in proteins by altering their allergenic capacity, as well as produce the fragmentation and/or degradation of genomic DNA. In this work, we analysed by means of Real-Time PCR, the influence of pressure and thermal processing through Instant Controlled Pressure Drop (DIC) on the detectability of hazelnut, pistachio and cashew allergens. The detection of targets in hazelnut, pistachio and cashew (Cor a 9, Pis v 1 and Ana o 1, respectively) is affected by the treatment to different extents depending on the tree nut. Results are compared to those previously obtained by our group in the analysis of different treatments on the amplificability of the same targets. Reduction in amplificability is similar to that reported for some autoclave conditions. Our assays might allow for the detection of up to 1000 mg/kg of hazelnut, pistachio and cashew flours after being submitted to DIC treatment in food matrices.
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Affiliation(s)
- Africa Sanchiz
- Food Technology Department, SGIT-INIA, Ctra. La Coruña Km. 7.5, 28040 Madrid, Spain; (A.S.); (C.C.)
| | - Carmen Cuadrado
- Food Technology Department, SGIT-INIA, Ctra. La Coruña Km. 7.5, 28040 Madrid, Spain; (A.S.); (C.C.)
| | - Joseph Haddad
- Laboratory Engineering Science for Environment (UMR 7356 CNRS), La Rochelle University, Avenue Michel Crepeau, 17042 La Rochelle, France;
- Food Science and Technology Department, Faculty of Agriculture, Lebanese University, Dekweneh, 11111 Beirut, Lebanon
| | - Rosario Linacero
- Genetics, Physiology and Microbiology Department, Biology Faculty, Complutense University, 28040 Madrid, Spain
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24
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Cohen SR, Cárdenas-de la Garza JA, Dekker P, Haidari W, Chisolm SS, Taylor SL, Feldman SR. Allergic Contact Dermatitis Secondary to Moisturizers. J Cutan Med Surg 2020; 24:350-359. [PMID: 32293193 DOI: 10.1177/1203475420919396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Moisturizers are cosmetic products used routinely to manage various skin conditions. Even though moisturizers are often thought to have minimal or no adverse reactions, allergic contact dermatitis (ACD) to these products can develop in some cases. Methods: We studied ingredients included in 3 of the most commonly used moisturizer brands, identified their presence in standard patch testing series, and evaluated their allergenic potential, categorizing the allergens as frequent or infrequent. The standard patch testing series used as reference were the Thin-layer Rapid Use Epicutaneous patch test (T.R.U.E. test), the North American Contact Dermatitis Group (NACDG) screening standard series, and the American Contact Dermatitis Society (ACDS) core allergen series. Results: Aveeno, Cetaphil, and Cerave products had a total of 12, 14, and 9 potential allergens, respectively, the majority of which were infrequent and not included in standard patch testing series. Conclusion: Being aware of the allergenic potential of commonly used moisturizers may help healthcare providers when evaluating patients with ACD. Further testing is recommended in a targeted manner when suspecting ACD with negative standard patch testing series or when ACD is refractory to treatment.
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Affiliation(s)
- Stephanie R Cohen
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jesús A Cárdenas-de la Garza
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Paige Dekker
- 12230 Georgetown University School of Medicine, Washington, DC, USA
| | - Wasim Haidari
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,12230 Georgetown University School of Medicine, Washington, DC, USA
| | - Sarah S Chisolm
- 12239 Department of Dermatology, Emory School of Medicine, Atlanta, GA, USA
| | - Sarah L Taylor
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- 12280 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,12279 Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,12279 Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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25
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Pru p 9, a new allergen eliciting respiratory symptoms in subjects sensitized to peach tree pollen. PLoS One 2020; 15:e0230010. [PMID: 32191737 PMCID: PMC7082028 DOI: 10.1371/journal.pone.0230010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 02/19/2020] [Indexed: 11/26/2022] Open
Abstract
Peach tree (PT) pollen sensitization is highly prevalent in subjects living in areas where this tree is widely cultivated. None of the allergens responsible for these sensitizations have been identified so far. Our aim was to identify the most relevant PT pollen allergens and analyze their capacity for inducing respiratory symptoms. We studied sixty-two individuals sensitized to PT pollen who developed symptoms after its exposure. The IgE binding profile on peach pollen extract by means of immunoblotting using sera from these subjects was analyzed. Protein extract was fractionated by anion-exchange chromatography and HPLC, fractions run in SDS-PAGE and proteins were identified from IgE-binding bands by mass spectrometry. Several allergenic proteins in the PT pollen extract were recognized by patients’ IgE: a glucan endo-1,3-beta-glucosidase-like, a polygalacturonase, an UTP-glucose-1-phosphate uridylyltransferase and a PR-1a protein. This PR-1a protein is a novel allergen frequently recognized with a molecular mass of 18 kDa, named as Pru p 9 following the WHO-IUIS nomenclature. Skin Prick Test (SPT) performed with this allergen was positive in 41% of the PT pollen-sensitized clinical cases. Most of them had rhinitis or rhinoconjunctivitis, but a significant percentage experienced asthma with seasonal symptoms during the period of PT flowering. Nasal Provocation test (NPT) with Pru p 9 was positive in all cases with positive SPT to this new allergen eliciting nasal symptoms similar to those challenged with PT pollen. We demonstrate that PT pollen can induce sensitization and allergy in an exposed population, being Pru p 9 a relevant allergen responsible of respiratory symptoms. Considering the extensive peach worldwide production with a large number of people involved, our results add a great value for the diagnosis and management of subjects allergic to this pollen.
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26
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Ping JD, Zhao JW, Sun XX, Wu F, Jiang ZY, Cheng Z, Zheng L, Xue HK, Yang JJ, Ming L. Prevalence of allergen sensitization among 1,091 patients with urticaria. Exp Ther Med 2020; 19:1908-1914. [PMID: 32104248 PMCID: PMC7027159 DOI: 10.3892/etm.2019.8367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 12/05/2019] [Indexed: 12/27/2022] Open
Abstract
The etiology of urticaria is heterogeneous and allergic responses may be involved in it. The aim of the present study was to investigate the prevalence and distribution of sensitivity to inhaled and food allergens among patients with urticaria in Henan province (China). The levels of specific immunoglobulin E (sIgE) were detected using the AllergyScreen test and a total of 524/1,091 cases (48.0%) tested positive for sIgE to at least one of the 19 allergens. The most common inhaled allergens the urticaria patients were sensitive to were D. pteronyssinus (34.5%), cockroach (12.5%) and tree pollen mix (11.1%), while the food allergens with the highest rate of allergic reactions were cashew nut (8.1%), shrimp (6.8%) and crab (6.4%). The positive rates for D. pteronyssinus, dog hair, cockroach, mold mix, tree pollen mix and shrimp in the chronic urticaria group were higher than those in the acute urticaria group (P<0.05). Furthermore, positive rates for the majority of allergens were higher in males than in females and were significantly different between age groups (P<0.05). The results of the present study provided information on the characteristics of allergen sensitization of patients with urticaria and may facilitate the prevention, diagnosis and management of urticaria in Henan province.
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Affiliation(s)
- Jie-Dan Ping
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Jun-Wei Zhao
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Xiao-Xu Sun
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Fan Wu
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Zhi-Yun Jiang
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Zhe Cheng
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Lei Zheng
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Hai-Kuo Xue
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Jing-Jing Yang
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Liang Ming
- Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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27
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Mayorga C, Fernandez TD, Montañez MI, Moreno E, Torres MJ. Recent developments and highlights in drug hypersensitivity. Allergy 2019; 74:2368-2381. [PMID: 31557314 DOI: 10.1111/all.14061] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 12/12/2022]
Abstract
Drug hypersensitivity reactions (DHRs) are nowadays the third cause of allergy after rhinitis and asthma with a significant increase in prevalence in both adults and paediatric population with new drugs included as culprit. For this, DHRs represent not only a health problem but also a significant financial burden for affected individuals and health systems. Mislabelling DHRs is showing to be a relevant problem for both, false label of drug allergic and false label of nonallergic. All this reinforces the need to improve accurate diagnostic approaches that allow an appropriate management. Moreover, there is a need for training both, nonallergist stakeholders and patients to improve the reaction identification and therefore decrease the mislabelling. The use of allergy cards has shown to be relevant to avoid the induction of DHRs due to the prescription of wrong medication. Recent developments over the last 2 years and highlights about risk factors, diagnostic approaches, mechanisms involved as well as prevention actions, and management have been reviewed. In these papers, it has been outlined the need for correct diagnosis and de-labelling of patients previously false-reported as allergic, which will improve the management and treatment of patients with DHRs.
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Affiliation(s)
- Cristobalina Mayorga
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA‐ARADyAL Málaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga‐ARADyAL Málaga Spain
- Andalusian Center for Nanomedicine and Biotechnology‐BIONAND Málaga Spain
| | - Tahia D. Fernandez
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA‐ARADyAL Málaga Spain
| | - Maria Isabel Montañez
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA‐ARADyAL Málaga Spain
- Andalusian Center for Nanomedicine and Biotechnology‐BIONAND Málaga Spain
| | - Esther Moreno
- Allergy Unit Hospital Universitario de Salamanca‐ARADyAL IBSAL Salamanca Spain
| | - María José Torres
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA‐ARADyAL Málaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga‐ARADyAL Málaga Spain
- Andalusian Center for Nanomedicine and Biotechnology‐BIONAND Málaga Spain
- Universidad de Málaga Málaga Spain
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28
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Vélez-Pereira AM, De Linares C, Canela MA, Belmonte J. Logistic regression models for predicting daily airborne Alternaria and Cladosporium concentration levels in Catalonia (NE Spain). INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1541-1553. [PMID: 31377867 DOI: 10.1007/s00484-019-01767-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 05/21/2023]
Abstract
Alternaria and Cladosporium are the most common airborne fungal spores responsible for health problems, as well as for crop pathologies. The study of their behavior in the air is a necessary step for establishing control and prevention measures. The aim of this paper is to develop a logistic regression model for predicting the daily concentrations of airborne Alternaria and Cladosporium fungal spores from meteorological variables. To perform the logistic regression analysis, the concentration levels are binarized using concentration thresholds. The fungal spore data have been obtained at eight aerobiological monitoring stations of the Aerobiological Network of Catalonia (NE Spain). The meteorological data used were the maximum and minimum daily temperatures and daily rainfall provided by the meteorological services. The relationship between the meteorological variables and the fungal spore levels has been modeled by means of logistic regression equations, using data from the period 1995-2012. Values from years 2013-2014 were used for validation. In the case of Alternaria, three equations for predicting the presence and the exceedance of the thresholds 10 and 30 spores/m3 have been established. For Cladosporium, four equations for the thresholds 200, 500, 1000, and 1500 spores/m3 have been established. The temperature and cumulative rainfall in the last 3 days showed a positive correlation with airborne fungal spore levels, while the rain on the same day had a negative correlation. Sensitivity and specificity were calculated to measure the predictive power of the model, showing a reasonable percentage of correct predictions (ranging from 48 to 99%). The simple equations proposed allow us to forecast the levels of fungal spores that will be in the air the next day, using only the maximum and minimum temperatures and rainfall values provided by weather forecasting services.
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Affiliation(s)
- Andrés M Vélez-Pereira
- Department of Environmental Engineering, Engineering Faculty, Universidad Tecnológica de Bolívar, Cartagena, Colombia
- Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Concepción De Linares
- Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain.
- Department of Animal Biology, Plant Biology and Ecology, Universitat Autònoma de Barcelona, Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.
| | - Miguel-Angel Canela
- Department of Managerial Decision Sciences, IESE Business School, Barcelona, Spain
| | - Jordina Belmonte
- Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Animal Biology, Plant Biology and Ecology, Universitat Autònoma de Barcelona, Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain
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29
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Quality of Life in Patients with Allergic Reactions to Medications: Influence of a Drug Allergy Evaluation. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:2714-2721. [DOI: 10.1016/j.jaip.2019.05.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/20/2019] [Accepted: 05/13/2019] [Indexed: 01/08/2023]
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30
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García-Sánchez J, Trigo MDM, Recio M. Extraction and quantification of Ole e 1 from atmospheric air samples: An optimized protocol. CHEMOSPHERE 2019; 225:490-496. [PMID: 30897472 DOI: 10.1016/j.chemosphere.2019.02.155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/19/2019] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
Olive pollen is the main cause of pollinosis in Mediterranean countries. The immunological analysis of Ole e 1, the major allergen of Olea europaea, has usually carried out by means of ELISA (Enzyme-Linked ImmunoSorbent Assay). However, most published works only specify the methodology related to antigen quantifications, but not the related to protein extraction. Furthermore, the results obtained are not compared with different buffers or modifications of them. The main aim of this study is to obtain an optimized and reproducible ELISA protocol for quantifications of Ole e 1 in the atmosphere. The study of Ole e 1 allergen and olive pollen in the atmosphere of Malaga (Spain) was carried out by means of an automatic multi-vial cyclonic sampler and a Hirst volumetric pollen trap, respectively. ELISA was tuned up on the basis of previously published protocols to quantify this allergen. Variations in the concentrations of capture and detection antibodies, as well as in the buffers used to carry out the extraction, were evaluated. The highest protein extraction was obtained when a modified buffer was applied. The correlation analysis between daily pollen concentrations and allergen quantifications showed highly significant values. The ELISA protocol, together with the buffer combination proposed in this work, considerably reduced the concentrations of capture and detection antibodies used for quantifying Ole e 1 in the atmosphere, allowing detect this allergen even in days in which the airborne pollen concentration was very low or null.
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Affiliation(s)
- José García-Sánchez
- Department of Plant Biology, Faculty of Sciences, University of Malaga, Campus de Teatinos, E-29071, Malaga, Spain.
| | - Ma Del Mar Trigo
- Department of Plant Biology, Faculty of Sciences, University of Malaga, Campus de Teatinos, E-29071, Malaga, Spain.
| | - Marta Recio
- Department of Plant Biology, Faculty of Sciences, University of Malaga, Campus de Teatinos, E-29071, Malaga, Spain.
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Eguiluz-Gracia I, Tay TR, Hew M, Escribese MM, Barber D, O'Hehir RE, Torres MJ. Recent developments and highlights in biomarkers in allergic diseases and asthma. Allergy 2018; 73:2290-2305. [PMID: 30289997 DOI: 10.1111/all.13628] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/19/2018] [Accepted: 09/21/2018] [Indexed: 12/22/2022]
Abstract
The potential of precision medicine in allergy and asthma has only started to be explored. A significant clarification in the pathophysiology of rhinitis, chronic rhinosinusitis, asthma, food allergy and drug hypersensitivity was made in the last decade. This improved understanding led to a better classification of the distinct phenotypes and to the discovery of new drugs such as biologicals, targeting phenotype-specific mechanisms. Nevertheless, many conditions remain poorly understood such as non-eosinophilic airway diseases or non-IgE-mediated food allergy. Moreover, there is a need to predict the response to specific therapies and the outcome of drug and food provocations. The identification of patients at risk of progression towards severity is also an unmet need in order to establish adequate preventive or therapeutic measures. The implementation of precision medicine in the clinical practice requires the identification of phenotype-specific markers measurable in biological matrices. To become useful, these biomarkers need to be quantifiable by reliable systems, and in samples obtained in an easy, rapid and cost-efficient way. In the last years, significant research resources have been put in the identification of valid biomarkers for asthma and allergic diseases. This review summarizes these recent advances with focus on the biomarkers with higher clinical applicability.
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Affiliation(s)
- Ibon Eguiluz-Gracia
- Unidad de Alergia; IBIMA-Hospital Regional Universitario de Malaga-UMA; ARADyAL; Malaga Spain
| | - Tunn Ren Tay
- Department of Respiratory and Critical Care Medicine; Changi General Hospital; Singapore Singapore
| | - Mark Hew
- Allergy, Asthma and Clinical Immunology Service; The Alfred Hospital; Melbourne Victoria Australia
- School of Public Health & Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Maria M. Escribese
- Facultad de Medicina; Instituto de Medicina Molecular Aplicada (IMMA); Universidad San Pablo CEU; Madrid Spain
- Departamento de Ciencias Médicas Básicas; Facultad de Medicina; Universidad San Pablo CEU; Madrid Spain
| | - Domingo Barber
- Facultad de Medicina; Instituto de Medicina Molecular Aplicada (IMMA); Universidad San Pablo CEU; Madrid Spain
| | - Robyn E. O'Hehir
- Allergy, Asthma and Clinical Immunology Service; The Alfred Hospital; Melbourne Victoria Australia
- Department of Allergy, Clinical Immunology & Respiratory Medicine; Central Clinical School; Monash University; Melbourne Victoria Australia
| | - Maria J. Torres
- Unidad de Alergia; IBIMA-Hospital Regional Universitario de Malaga-UMA; ARADyAL; Malaga Spain
- Andalusian Center for Nanomedicine and Biotechnology - BIONAND; Malaga Spain
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